Provider Demographics
NPI:1346135092
Name:HERNANDEZ, LINDA LUPITA (EDS, MED, BCBA)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LUPITA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:EDS, MED, BCBA
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LUPITA
Other - Last Name:CORRAL/ AVELAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CORRAL/ AVELAR
Mailing Address - Street 1:1501 W CAMERON AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2724
Mailing Address - Country:US
Mailing Address - Phone:323-302-9997
Mailing Address - Fax:818-736-4189
Practice Address - Street 1:1910 ORANGE TREE LN STE 360
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-4528
Practice Address - Country:US
Practice Address - Phone:909-513-2002
Practice Address - Fax:818-736-4189
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-21-53673103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst